Last updated: Friday, 24, December, 2010
CausesAppropriate Tests

Clinical assessment; FBC, blood film, platelet count.

Further investigation is unlikely to be productive unless there are clinical features suggestive of vasculitis or there is a personal or family history suggestive of a bleeding disorder.

The bleeding time and Hess test are neither sensitive nor specific and are not appropriate.


Vasculitis, especially

'Senile purpura'

  • Elderly patient
  • Prolonged solar exposure
  • Corticosteroid excess
Usually seen in older, fair skinned patients who have had prolonged solar exposure, with purpura typically on the forearms and dorsa of hands.

See Cushing's syndrome


Porphyria cutanea tarda 

Not a true form of purpura but may sometimes be confused with it. The lesions are typical blistering and heal with scarring.